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| Author | Samples | Level of functioning of ASD sample | Aim of the study | Findings |
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| Bursch et al. [33] | 2 patients with the signs and symptoms of ASD. | Does not specify. | Case report of 2 patients and their sensory abnormalities and pain perception as observed by family. | Reported evidence of lack of pain sensitivity in both patients. That is, “…once grabbed a hot frying pan and did not seem to respond in a way typical of someone in pain.” |
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| Elwin et al. [56] | 17 works published in English or Swedish and 10 autobiographies. | Does not specify for individuals. | To explore hyper- and hypo-sensitivity in individuals with ASD in the context of verbal expression. Using samples of published autobiographies as a data source. | Yes, self-reported pain insensitivity.
Pain could be indistinctly experienced, and several authors pointed out having a very high pain threshold. Injuries could easily go undetected. |
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| Mieres et al. [32] | 9 year old with pervasive developmental disorder, not otherwise specified. | Does not specify. | To describe how a nurse and a physical therapist in an interprofessional (IP) school-based clinic collaborated to meet the needs of a child with PDD-NOS, with atypical classroom behaviours and declining student performance. | Yes: parental report of pain insensitivity.
For this student, pain was an unreliable indicator of both a dental infection and piercing of skin by thorny objects.
Child was referred to a dentist who discovered a severe abscess affecting two teeth. The dentist reported that an abscess of this size without pain is unusual, given the size, the depth, and the proximity to bone. |
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Ross-Russell and Sloan [17] | 7-year-old boy. | Mild ASD. | Report of a case of a young child with mild ASD who presented with unexplained dental pain and who subsequently went on to extract his own lower right deciduous canine tooth. | Yes, suggestion that this patient had pain insensitivity.
“He has also demonstrated SIB in the form of head banging. He was brought to the clinic complaining of pain of about one week’s duration that was increasing in intensity which was present most of the time and was not sensitive to hot, cold or sweet stimulus. Within 24 hours the patient was again back at the clinic, as the pain had not resolved with ibuprofen, and by this time his lower right deciduous canine was very slightly mobile. No evidence of alveolar bone loss and the tooth had normal root anatomy. By the next day the patient had extracted his lower right deciduous canine tooth, witnessed by his mother. He claimed it had been ‘itching’ him until he got it out.” |
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| Rutherford [58] | Twins: boy who was diagnosed with ASD at 3 years and 1 month, and a girl who developed typically. | Does not specify. | Describes the development of an infant who was later diagnosed with ASD. Directly compares his development to that of his twin from a prenatal period through to the age of 4 years. Explored through examination of personal journals and medical records kept by the mother. | Yes: evidence of pain insensitivity—maternal observations.
N.F. frequently showed insensitivity to pain which was exhibited as early as 6 to 12 months of age. |
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